Ischaemic aetiology predicts exercise dyssynchrony in patients with heart failure with reduced ejection fraction

Stępniewski, Jakub; Kopeć, Grzegorz; Magoń, Wojciech; Podolec, Piotr

doi:10.5603/kp.a2018.0148

Cited by 2 publications

(3 citation statements)

References 33 publications

(38 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some patients with diastolic dyssynchrony at rest experienced diastolic resynchronization during exercise, while some of those without diastolic dyssynchrony at rest, became dyssynchroneous at exercise. Although such dynamic features have previously been attributed to systolic dyssynchrony in patients with HFREF [ 7 , 14 ]. According to available research this is the first report on the dynamic nature of diastolic dyssynchrony.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Diastolic dyssynchrony and its exercise-induced changes affect exercise capacity in patients with heart failure with reduced ejection fraction

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background: Left ventricular diastolic dyssynchrony is common in patients with heart failure with reduced ejection fraction (HFREF). Little is known however, about its pathophysiology and clinical effects. Herein is hypothesized that presence of diastolic dyssynchrony at rest or at exercise may importantly contribute to HF symptoms. The aim was to investigate the influence of diastolic dyssynchrony and its exercise-induced changes on exercise capacity in HFREF patients. Methods: Patients with stable, chronic HF, left ventricular ejection fraction < 35%, sinus rhythm and QRS ≥ 120 ms were eligible for the study. Rest and cyclo-ergometer exercise echocardiography were performed. Diastolic dyssynchrony was defined as opposing-wall-diastolic-delay ≥ 55 ms measured in tissue-Doppler imaging. Exercise capacity was assessed by peak oxygen consumption (VO 2peak ). Association between diastolic dyssynchrony and VO 2peak was assessed in univariate regression analysis and further adjusted for possible confounders. Results: Fourty eight patients were included (aged 63.7 ± 12.2). Twenty-seven (56.25%) had diastolic dyssynchrony at rest and 13 (27%) at exercise. Twenty-two (46%) experienced a change in diastolic dyssynchrony status during exercise. In univariate models diastolic dyssynchrony at rest or at exercise were associated with lower VO 2peak (beta coefficient = -3.8, p = 0.004; beta coefficient = -3.6, p = 0.02, respectively). However, the ability to restore diastolic synchronicity during exercise was associated with higher VO 2peak (beta coefficient = 3.4, p = 0.04) and remained an important predictor of exercise capacity after adjustment for age and HF etiology. Conclusions: The ability to restore diastolic synchronicity at exercise predicts exercise capacity in patients with HFREF.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Data on the influence of diastolic dyssynchrony on exercise capacity in patients with HFREF is lacking. It was also unknown as to whether diastolic dyssynchrony is prone to change during exercise as had previously been reported with regard to systolic dyssynchrony [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Diastolic dyssynchrony and its exercise-induced changes affect exercise capacity in patients with heart failure with reduced ejection fraction

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…Heart failure with preserved ejection fraction SE has been extensively validated in patients with heart failure with reduced ejection fraction. [22][23][24] Left ventricular contractile reserve is associated with a greater chance of response to the cardiac resynchronization therapy. 23,25 Shortness of breath, exertional fatigue, or poor exercise capacity has been increasingly recognized as the consequence of diastolic dysfunction and considered to be the main cause in approximately 40% of patients presenting with heart failure.…”

Section: Paradoxical Low -Flow Low-gradient Aortic Stenosismentioning

confidence: 99%

The role of stress echocardiography in cardiovascular disorders

Ágoston¹,

Morvai-Illes²,

Pálinkás³

et al. 2019

Kardiol Pol

View full text Add to dashboard Cite

Stress echocardiography is a safe, low-cost, widely available, radiation-free versatile imaging modality that is becoming increasingly recognized as a valuable tool in the assessment of coronary heart disease. In recent years, there has also been an increasing use of stress echocardiography in the assessment of nonischemic cardiac disease given its unique ability for simultaneous assessment of both functional performance and exercise-related noninvasive hemodynamic changes, which can help guide treatment and inform about the prognosis of the patients. Today, in the echocardiography laboratory, we can not only detect wall motion abnormalities resulting from coronary artery stenosis, but also detect alterations to the coronary microvessels, left ventricular systolic and diastolic parameters, heart valves, pulmonary circulation, alveolar-capillary barrier, and right ventricle. The role of stress echo has been well established in several pathologies, such as aortic stenosis and hypertrophic cardiomyopathy; however, other indications, namely the results of diastolic stress testing and pulmonary hypertension, need additional data and research. This paper presents the current evidence for the role of stress testing in mitral regurgitation, aortic stenosis, hypertrophic cardiomyopathy, heart failure with preserved ejection fraction, and pulmonary hypertension.

show abstract

Ischaemic aetiology predicts exercise dyssynchrony in patients with heart failure with reduced ejection fraction

Abstract: Ischaemic aetiology of HFREF is an important predictor of ExDYS. Restoration of LV synchronicity during exercise is more likely in patients with less advanced LV diastolic dysfunction.

Cited by 2 publications

References 33 publications

Diastolic dyssynchrony and its exercise-induced changes affect exercise capacity in patients with heart failure with reduced ejection fraction

Diastolic dyssynchrony and its exercise-induced changes affect exercise capacity in patients with heart failure with reduced ejection fraction

The role of stress echocardiography in cardiovascular disorders

Contact Info

Product

Resources

About